15 Important Decisions to Make Before You Go Into Labor
April 14, 2021
Moms-to-be have a lot of tasks on their pregnancy checklist, from prepping the nursery to washing baby clothes, freezing meals and packing your hospital bag. But in addition to those to-dos, there are several important decisions you’ll have to make before your due date rolls around—because when it comes to childbirth, you do have some options. Here, we’ve listed out some of the major choices you have before you. Take a peek, do some research and talk to your doctor about what’s feasible and what makes sense for you.
It’s never too early in pregnancy to think about whether you’d like to give birth in a hospital, birthing center or at home. That’s because this decision may impact who you choose as your healthcare provider. Ob-gyns typically have admitting privileges to specific hospitals (so check if that’s where you want to deliver) and don’t do home births. Some midwives, but not all, can deliver at hospitals in addition to birthing centers, and some will attend home births—it all depends on the individual. If you find that you need to switch doctors, it’s best to do it sooner rather than later. Providers will usually accept new patients up to 32 or 34 weeks, but after that it gets trickier (although not impossible). If you opt for a hospital or birthing center setting, consider setting up a tour (if possible) to get a sense of the space and learn the policies and procedures.
Think about how you’d like to manage your pain during childbirth. Maybe you’re going to opt for an epidural, or maybe your plan is try HypoBirthing during an unmedicated birth—there are a lot of options out there. It’s helpful to consider your choices a few months before your due date, since your decision may affect where you give birth; if you’re hoping to get an epidural, for example, a hospital is the best setting for you. That would also leave you enough time to take a childbirth class in a specific technique, like the Bradley Method, which involves a 12-week course. If you deliver in a hospital, though, know that you can make your final choice in the moment. If you’ve been laboring for hours and decide an epidural sounds pretty nice, you can (generally) get it at any point. If you were planning on a medicated birth but find the pain isn’t actually all that bad (lucky you), skip the drugs and power through. After all, you never know how childbirth is going to go.
The American Academy of Pediatrics (AAP) recommends that mothers breastfeed exclusively for the first six months, followed by breastfeeding in combination with solid foods for at least a year—but at the end of the day, breastfeeding is a personal choice. Read up on the benefits and consider your needs and lifestyle, and decide whether you’d like to (at least try to) breastfeed your newborn. If you do, you may find it helpful to take a breastfeeding class to help you prepare, and stock up on any nursing essentials you may need (like a breast pump, breast milk storage bags, nipple cream, a nursing pillow, etc.). It’s also a smart move to research lactation consultants in your area who you can turn to with any questions or problems once baby arrives. Let your doctor and delivery nurses know of your decision–if you plan to breastfeed, they can help you get baby to latch as soon as possible after birth, and if you don’t, they will know not to keep asking.
Regardless of where you decide to deliver, think about whether you’d like to hire a doula. A doula is essentially a birth coach—someone who’s been trained in offering physical, emotional and educational support for moms. Instead of offering medical care, they help guide and encourage you through labor. The exact services they offer will depend on the individual, but they might offer a pre-birth consultation where they go over your birth plan and answer questions; guidance during labor, where they instruct you on different birthing positions and breathing techniques and massage your aching body; and postpartum support, where they help with breastfeeding issues and maybe even perform light household chores. If you decide you want a doula by your side, leave time (ideally a few months) to interview potential doulas and find a good fit.
Newborns get checkups right away. Baby will get a routine exam in the hospital within 24 hours of birth (either by a staff doctor or your chosen pediatrician), and then go to their first wellness checkup outside the hospital within the first week—so you’ll need to have a pediatrician lined up before baby arrives. Early in your third trimester, start interviewing potential candidates to find a doctor who feels like a good fit for your family.
Cord blood banking is the process of collecting and storing the blood left in a newborn’s umbilical cord so it can be used for future medical purposes, such as transplants, cancer treatments and more. You can opt to store the cord blood in a private bank for a fee or donate to a public cord blood bank. If you decide to move forward with banking, you’d need to select a bank and get the collection kit at least six weeks before your due date, and alert your doctor of your decision so they can be prepared to collect the blood immediately after birth. Research the pros and cons of cord blood banking and decide whether it’s right for your family.
If you decide to move forward with cord blood banking, you won’t be able to delay clamping the umbilical cord, otherwise the blood will clot and render it useless. However, if you’re not planning to bank, consider whether you want your doctor to hold off clamping baby’s umbilical cord for several seconds or minutes. While cord clamping immediately after birth had long been standard procedure, recent research has found that waiting to cut the cord may have a host of immediate and longer term benefits, especially for preemie babies but also for those born full-term, without posing a risk of blood loss for the mother. The American College of Obstetricians and Gynecologists recommends delaying cord clamping for at least 30 to 60 seconds, while the Word Health Organization recommends at least one minute and the American College of Nurse-Midwives recommends 2 to 5 minutes. Talk to your doctor about your options and preferences.
Within about 30 minutes after giving birth to baby, your body will expel the placenta. Many women give it no second thought, but others choose to keep the placenta for various reasons. In certain cultures, burying it is symbolic of the child’s link to the earth. In other cases, some mothers consume it in smoothies or placenta pills in the belief that it helps promote postpartum recovery and can boost your mood, energy and breast milk production. These benefits aren’t backed by research, and the Centers for Disease Control and Prevention warns against eating placenta, even in capsule form, since it can lead to infection in you or baby and blood-borne cross-contamination. If you do want to save your placenta, let your doctor know ahead of time so it can be properly stored. And if consumption is your plan, consider lining up a professional service that’s experienced in placenta encapsulation to help lower the risk.
In the US, just over half of boys are circumcised for religious or social reasons. Medically speaking, there are some benefits to circumcision, including a lower chance of developing urinary tract infections in the first year of life and contracting sexually transmitted infections and HIV later in life. There are also some risks, such as bleeding and swelling, as well as the issue of pain, although experts say there are several safe, effective ways to reduce the pain for newborns. The AAP says the benefits generally outweigh the risks, but the benefits aren’t so great that they recommend circumcision for every baby boy. Instead, they leave the decision up to parents based on their religious, cultural and ethical beliefs.
Babies are born with very low levels of vitamin K, which is what the body uses to form clots and stop bleeding. To prevent life-threatening bleeding due to vitamin K deficiency, an injection of vitamin K is usually given to newborns at birth. In some states the shot is required by law, but in others parents have the right to decline. According to the CDC’s immunization schedule, newborns should also receive their first dose of the Hepatitis B vaccine at birth. You’ll need to sign a consent form before the shot is administered. Vaccines help the body fight off dangerous diseases and are highly encouraged by the CDC, but read up on vaccines so you can make an informed decision.
Before you put together a lengthy list of the VIPs you’d like by your side in the delivery room, first check with your hospital or birthing center to learn how many people are allowed in the room, per their usual and COVID-19 related policies. Some places may limit it to the mom plus one other person, while others may allow more people and have less restrictions. Once you know how many you’re allowed, you then have to decide who you actually want. Are you picturing just you and your partner, or would you like having the support of family members or friends? If you’re planning to have a doula, don’t forget to include them in your count. Also think about when you’d like your support people in the room—maybe you’d invite certain people to stay with you during labor but would prefer more privacy once it’s time to push. It’s all up to you.
Also known as kangaroo care, skin-to-skin care involves placing the naked baby directly onto your (or your partner’s) bare chest. The contact has been proven to help newborns—both those born full-term and premature—regulate body temperature and stabilize their vital signs, soothe their cries and lead to better weight gain and breastfeeding success. If you choose to do kangaroo care, depending on hospital policy, you can ask that your newborn be placed on your chest as soon as they’re born, potentially even if you’ve had a c-section. Talk to your doctor about your options.
Babies are born covered in a waxy, white substance called the vernix. For a long time, standard care was to give newborns a sponge bath a couple hours after birth to remove the vernix—but in recent years, experts are seeing benefits to delaying that first bath by 24 hours. Not only does the vernix help keep new babies warm, thereby also regulating their blood sugar, but it also gives new moms more time to bond and do skin-to-skin care. But delayed bathing isn’t always possible, depending on medical circumstances. Chat with your doctor about what might be possible.
Pacifiers are a classic symbol of infanthood, but there are pros and cons to using them. They’ve been shown to reduce the risk of SIDS and help preemies thrive, among other positives, but long-term use can also lead to dental problems and ear infections. Read more about the risks and benefits and decide what you’re comfortable with and, if using, when you’d like to introduce a pacifier. (Some say to wait until breastfeeding is established, while others say it’s fine to use from the get-go). It’s helpful to figure out what you’d prefer before giving birth—that way if your newborn is staying in the hospital nursery or NICU, you can tell the nurses whether you’re okay with them offering baby a pacifier.
You’ve decided where you’d like to deliver and who you’d like to be beside you—now it’s time to think about what kind of mood you’d like to set in the delivery room. A lot of moms like the idea of curating a playlist of songs for labor and delivery to either help relax or motivate them. Some choose to bring essential oils and a diffuser into the room to help them de-stress. And some women wanting a tranquil atmosphere hang a “quiet” sign on their door so nurses know to lower their voices. Think about what will make you as comfortable as possible!
As you research and consider all your choices, record your preferences in your birth plan and review it with your doctor leading up to your due date. You can also print out a few copies to bring with you to the hospital or birthing center and share with your nurses. Just remember that childbirth is full of unknowns, so keep your preferences flexible and trust the medical and support team you’ve assembled to shepherd you through this life-changing experience.
Updated April 2021